The Arrogant Highs

Last time I wrote about Maslow's Pyramid. What follows is based on that conceptual framework. So if you have not already read the last posting you may want to. Maslow called his model of human development and behavior the Hierarchy of Needs. I call my model of the addiction process, based in his ideas, the "Lowarchy of Highs." Lowarchy is a neologism and you will not find it in the dictionary. I use this made up term to emphasize the negative (downward) progression of addiction. The Hierarchy builds from the bottom up. The Lowarchy destroys from the top down.

The first highs are the best highs. These are at the summit of the Lowarchy. These highs correspond to the Self Actualization Needs on Maslow's Pyramid. Achieving the Actualization Needs involves a life of effort and self-exam. All you have to do to achieve these initial highs is, get high, take the drug, smoke it, drink it, snort it or inject it and this is as good as it will ever get! These initial highs I call the Arrogant Highs.

They are not called the Arrogant Highs because people who get high are arrogant. Some perfectly humble people just might decide to get high. The high they experience will not be so humble. It may give them an on top of the world feeling, euphoria. But these people are not on top of the world they're just high. And that's why these highs are called the Arrogant Highs. Some examples may help to explain the Arrogant Highs.

If you wanted to meet a room full of experts on any subject where would you go? If you wanted to hear from experts on economics, geopolitics, marriage, national defense and auto-mechanics where could you go to find experts on all these and many other subjects? A university? A library? A church? No! None of those places have all the expertise readily available. However you can walk into almost any bar in any town, anywhere and find a room full of experts on these and many more subjects as well. These experts will gladly and endlessly share the vast knowledge with you! But, are they really experts, or are they just drunk?

You might be a shy, reticent and self effacing individual the essence of humility. But snort a line of cocaine and SHAZAM! You are the coolest, smartest, sexiest person around! The life of the party.

A number of years ago a lady brought her son to see me. She was concerned because he regularly smoked marijuana seemed to be developmentally stuck and was going nowhere fast. He was 20 years old, a high school dropout, unemployed, and lived with his mother. I met with him in private. With his mother away this young man confided in me that besides his routine use of marijuana he had recently begun experimenting with LSD.

This young man told me that on his most recent acid trip he had gotten "the answer." I asked, "The answer to what?" He responded, "No it's not like that man." I queried, "Do you mean like, the answer to God the universe and everything?" He said, "Yeah like that, the BIG answer!" I asked, "What is it?" He replied, "I could tell you, but you wouldn't get it." He continued, "So I am going to write a book and as you read the book the answer will gradually occur to you," adding, "and I'm not even going to charge any royalties for this book, because I just wouldn't feel right about it!"

Now my friends, the above is a great example of an Arrogant High! Here was a young man, 20 years old, unemployed, a high school dropout, who smokes pot every day and lives with his mother and he has the answer to everything! If I have any questions, any at all, about anything, I am not going to consult this young man, what can he tell me, fire up a fat boy and chill? Yet despite all the evidence to the contrary his Arrogant High has him believing he knows the inside dope about everything.

The Arrogant Highs are really good highs. If you question someone using for an Arrogant High about their drug use they will actually feel sorry for you. They will find you pitiful. After all you just don't get it you are a square an object of scorn.

A person using drugs for an Arrogant High will not work to meet their Self Actualization Needs. Why should they? using a drug puts them on top of the world without any real effort on their part.

Sooner or later the Arrogant Highs fade. They are replaced by another set of highs. Highs not quite as good as the Arrogant Highs but, still pretty good highs. These next highs correspond to slightly more basic needs. They displace these needs, just as the Arrogant Highs displaced the Self Actualization Needs. More about them next time.





Russell P. Mai, LCDC, AAC

Maslow's Pyramid

I had been working for a number of years with teenagers under the supervision of the juvenile justice system when I had the opportunity to give presentations at a high school. One of the classrooms to which I talked was an advanced placement class. These students were so much more mature and attentive than the teens I generally dealt with that I suddenly realized how little I knew about healthy adolescents.

I have a strong feeling that mental health professionals in general have a rather jaded view of humanity which is product of their overexposure to dysfunctional individuals and groups. The increasing integration of addiction professionals into the mental health community has corresponded with an increase in the diagnosis of mental health disorders in substance disordered individuals. Coincidence? Perhaps. Still even the most objective professionals tend to identify the disorders they have been trained to find.

One of my heroes is the late American psychologist, Abraham Maslow. Maslow was the first psychologist to study healthy people. I believe that understanding Maslow's ideas is important. In my view understanding Maslow is a prerequisite to understanding the addiction process. Like many prerequisites it's full importance to what comes later is not self evident so please bear with me and have faith that what follows will help later with your comprehension of addiction.

Maslow's called his model of human psychology "The Hierarchy of Needs." Most people call his model "Maslow's Pyramid" (for obvious reasons). Maslow put forward the idea that people do the things they do in order to get their needs met. He said these needs are hierarchical in nature. Meeting the most basic needs takes precedence over meeting less basic needs. Meeting the needs approaching the summit of the hierarchy is rewarding in ways vastly different than the rewards of meeting the needs at the base of the hierarchy. The model graphically depicts the necessity of meeting the more basic needs (those near the base) before the higher level needs can be met. After all you cannot build on nothing. Only after all the lower level needs have been met can the uppermost level of needs be addressed. This is why hardly anybody ever gets these needs met!

At the base of Maslow's Pyramid are the Physical Needs. These most basic needs are concerned with immediate survival. They include, food, water, and respiration. Most of the time we take these for granted. We just assume these needs will be met. Therefore most of us are not motivated on a day to day basis by these most basic needs. Natural disasters can alter our motivations. Following natural disasters people who had taken these most basic needs for granted may suddenly be motivated by hunger or thirst. In the case of fire they may be motivated by the need to respire.

The next level on the Hierarchy is the level of Safety and Shelter Needs. People sometimes have difficulty understanding why food and shelter are on different levels of the Pyramid. The reason is, starving people (or animals) will risk their safety and shelter in order to eat. For instance during the initial U.S. assault on Afghanistan our forces dropped both bombs and rations. Cluster bombs were dispersed widely as were packages of food. Sometimes the cluster bombs did not explode immediately on impact. Both the bombs and the food aid were contained in yellow packages. Starving Afghans would risk being blown to smithereens in order to get something to eat. This dire example clearly illustrates why these two needs are on different levels of Maslow's Pyramid.  http://articles.cnn.com/2001-11-01/us/ret.afghan.fooddrops_1_cluster-bombs-unexploded-cluster-bomblets?_s=PM:US

The two levels of needs described above are collectively known as the Survival Needs. This is because we will not survive if these two levels of needs go unmet. Meeting the Physical Needs is an immanent requirement for survival whereas meeting Safety and Shelter Needs is a long-term survival requirement.

The next level on the Hierarchy of Needs is the Belonging Needs. Meeting these needs is not required for survival. Survival without a sense of belonging would however be a fairly bleak prospect. Most of us have known the misery of loneliness at some time or another. We have a strong desire for love and companionship. Life does not seem worthwhile without these needs being met. Ideally our need to belong will be met through having a happy and healthy family, wholesome love relationships and high quality friendships. The Belonging Needs are so strong that people frequently settle for less than ideal friendships, less than ideal relationships and less than ideal families. Some people even settle for downright unhealthy situations just in order to fit in, belong or experience a twisted sort of affection.

Once we experience belonging another set of needs arise. These are the Esteem Needs. Esteem Needs are the desire for both self-respect and the respect or admiration of others. If you are a parent you probably want your children's respect. If you have parents you probably would like them to be proud of you. If you are in a relationship you most likely want your other half to appreciate you and are displeased if they take you for granted. Likewise as an employee you want your employer to appreciate your hard work. If you supervise others you also want their respect. Maslow said most of us spend our time trying to get these needs met. Personally I think he may have been a little optimistic, it seems to me that lots of people are just trying to survive (Maslow was an American living at a time when our economy was booming).

This is an appropriate point to reinforce the point that meeting higher level needs depends upon having all the lower level needs met. If a person is starving to death they will be desperate for food, any food. They would even be willing to eat from a dumpster if that was the only place they could find something to eat. If another person came across them eating from a dumpster and dared to question how they could behave in such a demeaning manner, their understandable response might be, "What are you talking about? I'm starving to death!" If you are starving your life is based on meeting your Physical Needs and someone suggesting your choice of cuisine is demeaning (Esteem Needs) would make no sense at all! If you are living at the level of Physical Needs you do not experience Esteem Needs. On the other hand offering shelter to a starving person might pique their curiosity and they will probably be interested once they have eaten their fill. This will be important later when looking at addiction.

Just as in the Belonging Needs it would be nice if people always achieved their Esteem Needs in healthy ways. This is unfortunately not always the case. If a child cannot impress his parents through high achievement he may start impressing them through low achievement. If a person cannot earn respect in healthy ways they may earn it in unhealthy ways such as bullying others. Healthy means of meeting the Esteem Needs are likely more sustainable than unhealthy means. Still advertisers have learned to sell us all kinds of unnecessarily expensive products based on our desire to impress ourselves and others. Achievement is the true route to meeting our Esteem Needs, and the only sustainable method in the long-run.

The highest level on Maslow's Pyramid is the Self-Actualization Needs. Abraham Maslow estimated that less than 1% of people ever meet their Self-Actualization Needs. Most will never even be aware of these needs. The lucky Self-Actualized few have a wonderful feeling of connection. They know they are fulfilling their special purpose. They believe they are living the life they were born to live. They are becoming the people whom their creator (if they believe in one) had in mind on the day they were born!

This is a cursory examination of Maslow's Hierarchy of Needs. Maslow was unique in studying healthy people and what motivates healthy individuals. His views are at once commonsense, idealistic and optimistic. Next we will use Maslow's concepts to help us understand the process of addiction.




Russell P. Mai, LCDC, AAC

The Advantages of Drugs and Alcohol

There are some people who seem to become immediately addicted once they try drugs or alcohol. For most it seems to take some time to become addicted. The length of time varies significantly. There is a period between first use and addiction during which substance reliance develops. Before we become dependent substances we first become reliant on them. I became aware of this important aspect of addiction over a period of time.

I used to be involved with a drug prevention program aimed at kids. The premise behind our efforts was kids use drugs because they are lacking in self-esteem. I doubted this as I recalled having fairly healthy self-esteem when I started using alcohol then marijuana and later LSD. Some of adolescents I encountered in prevention classes seemed extremely self assured despite their positive attitude about drug use!

The Houston PBS station once televised a series on sex addiction presented by Patrick Carnes author of, Out Of The Shadows. He was of course focused on sex but I think his explanation of how intelligent, competent people, from good families, can become reliant on sex, also works for drugs and alcohol.

I will do my best to explain. At the simplest we could just say that people drink and use drugs because it is fun to do so. This is pretty accurate but it is too broad to be useful. The other extreme would be to say that every individual uses drugs and alcohol for individual reasons. Also accurate but way too narrow to be useful. Patrick Carnes listed four desires he said people choose to meet through sex. I liked his list, so I co-opted it!

The first of these desires is escape, the second is excitement, the third mystery, and the last fulfillment. There is absolutely nothing wrong with any of these desires! We all want to escape from time to time there is nothing neurotic about the desire to get away form it all upon occasion. Similarly we need some excitement, some of us need quite a lot, others just a bit. Everyone has a degree of curiosity, and that curiosity creates a desire for mystery. And who wouldn't want to feel fulfilled? No one that's who. How do we normally go about meeting these desires? Typically in lots of normal ways like the ones listed below.

Typical ways of escaping our routine might be, reading, watching TV or going to the movies, taking a trip, watching sports, shopping or going fishing. We might find it exciting to ride a motorcycle or practice martial arts. We might find online gaming exciting, or roller-blading, dancing, or going to concerts. Going on a blind date could be mysterious, so could dining on ethnic foods, reading a mystery or foreign travel. We all want fulfilling careers, or at least hobbies. We look for fulfillment from our family life, in friendships and in our religious or spiritual life.

Okay now it is time to get real. Escaping into a book requires an interesting read and the ability to focus, sometimes our problems may be too pressing. TV is often boring and movies take planning and then some fool keeps talking during the show! You go on a trip only if you can afford it and are allowed time off, then when you get there it looks just like any other place - fast food and tourist trinkets. You may not catch any fish, there is nothing to buy on your shopping trip or it all costs too much! Sometimes there is no escape. Excitement; Motorcycles are expensive and no fun in bad weather. Martial arts involves repetitive exercises  that are not all that exciting. Online gaming can get old fast, after a while all the games seem the same. Roller-blading requires skill and decent weather or you have to do it indoors going round and round in a circle. Concerts are expensive and the band you want to hear never plays locally more often than every few years. Mystery; Your blind date shows up and it's your ex! The ethnic food you order smells bad and tastes worse. You solve the mystery you're reading by chapter three. Fulfillment; Sometimes family life is more trying than fulfilling, friends sometimes take but don't give and listening to sermons gets boring!

I know I am painting a bleak picture, the point is all the above ways of escaping, finding excitement or mystery or achieving fulfillment involve luck or skill or money or can only happen occasionally or need others to cooperate. Sometimes, perhaps frequently they do not work out as well as we had hoped they would.

Using drugs and alcohol has advantages over the above methods of achieving our desires for escape, excitement, mystery and fulfillment. For one thing drugs and alcohol are relatively cheap. It's a lot cheaper to get drunk or high than it is to take a trip, buy a motorcycle or raise a family.

Using drugs and alcohol requires very little skill. Keeping crack crackling is something people master rapidly.  Playing golf requires skill, mastering martial arts takes discipline, taking a course in astrophysics is hard work and gaining fulfillment through spiritual practices requires devotion but getting loaded is easy.

A person can use drugs or alcohol anytime they want to. Fishing requires appropriate conditions, hang gliding also requires the correct conditions, gazing at the stars through a telescope requires a dark clear night away from city lights, engaging in a fulfilling career requires a confluence of many circumstances, using narcotics just requires Internet access or access to a pain clinic or two.

The cooperation of others is not required in order to get drunk or high, not so if you want to veg-out watching TV and your spouse wants to talk, or you are excited by the prospect of having sex but your partner isn't, you cannot go on a blind date by yourself, family life requires a family, all these require others cooperation but you can peak on LSD in complete isolation.

Finally when it comes to luck drugs and alcohol have it all over these other methods of reaching our desires. Catching fish requires some luck, so does watching sports for excitement, or solving a puzzle even having a good relationship requires a fair amount of luck. Not so with drugs and alcohol, you can depend on them, they are reliable.

The truth is drugs and alcohol have all kinds of advantages; they are relatively cheap, they are readily available anytime anywhere, they are easy to use - the drug does all the work, and they are reliable, they consistently work the way you expect them to work. None of those other means of reaching our desires have all these advantages. That is the problem! The problem is not that drugs don't work. The problem is that they do!

It is because of the easy access, relative cheapness, ease of use, no assistance needed and reliable efficacy of drugs and alcohol that intelligent, well mannered, self confident, people from good homes wind up relying on them. We need to admit the truth and understand that everybody, smart or stupid, crazy or sane, is vulnerable to the advantages of drugs. They work and that is the problem!

The advantages of drugs and alcohol lead people to rely on them. Too often reliance devolves into dependence. It is subtle process that happens before we realize it. More about that later.






Russell Mai, LCDC, AAC

Is The Big Book of AA Still Relevant?

A number of years ago I was concluding a counseling session with a client. He was in his 30's and wasn't happy about his alcohol dependency but grudgingly accepted it. I suggested he attend AA and read their book as a means of gaining acceptance of his alcoholism. He didn't much care for this suggestion.

This man described AA in rather condescending terms. He seemed to feel it was for stupid people. Perhaps he had attended a meeting and had heard someone say "you can be too smart for this program but you can't be too stupid." I wish people wouldn't say things like that as it might run some people off. I suggested he might try a different meeting and give the AA "Big Book" a read. He clearly was not ready for a solution because he rejected this suggestion. (When you go to someone for advice and then reject the advice that is clear evidence you do not want a solution.) He added that the Big Book was out of date having been written prior to WW II. He said he would like something newer, more up to date, something based on science unlike the Big Book.

Now here was a question which gave me some pause. Sure I liked the Big Book and believed it to be just about the most helpful book ever written, but how well does it align with current knowledge about addiction? Well actually it does remarkably well.

Approximately a decade and a half after the Big Book was written the American Medical Association [AMA] first recognized alcoholism as a disease. The AMA definition of addiction has been amended recently specifying that addiction is a brain disease. This not withstanding the older wording remains describing alcoholism as a "primary, progressive and chronic," illness with characteristics such as "obsession" with alcohol, a "compulsion" to continue drinking once drinking is initiated and ongoing drinking "despite negative consequences." The definition from the AMA includes "distortions in thinking, most notably denial."

The description of alcoholism contained in the Big Book of AA includes all of the above. The Big Book states that "over any considerable period we get worse never better." This is a clear statement about the progressive nature of addiction. Denial is described in the Big Book as "The idea that somehow, someday he will control and (emphasis is mine) enjoy his drinking is the great obsession..." Actually the entire AMA definition of alcoholism is really a summary of the first 164 pages of the Big Book.

What about these latest brain disease findings? http://www.drugabuse.gov/publications/science-addiction/drugs-brain A few years ago a friend and I happened to be attending a lecture on addiction and the brain at UTMB Galveston. The talk was based on ten years of recent research. The speaker described how for persons with a history of addiction certain neuropathways are bypassed and others are selected when the subject is presented with a visible stimulus related to the substance they are or were addicted to. Basically all the pathways involved with inhibition and judgement are bypassed and those involved with instinctive actions are selected. In other words the subject was found to be "powerless over alcohol" his or her decisions evidenced that "our lives had become unmanageable."

The truth is that the Big Book is not a science book as such. It is not based on decades of controlled experimentation. However the hypothesis put forward by the Big Book has been validated by years and years of experimental evidence. The ideas contained in the Big Book of AA represent a theory of alcoholism and actually a theory of addiction which appears incontrovertible. Unless future research entirely negates current knowledge your best bet for comprehending and overcoming addiction are contained in the pages of the book Alcoholics Anonymous.


Russell Mai, LCDC, AAC